Clinical outcomes and mortality risk among inborn and referred newborns admitted to hospitals in Kenya

ABSTRACT Background Newborns requiring inpatient care, particularly small and sick newborns (SSNBs), face high risk of mortality. Newborns referred from other facilities may experience worse outcomes than those born and managed within the same hospital ( inborn newborns ). Understanding factors contributing to this disparity in outcomes could support efforts to scale-up care and accelerate progress towards achieving Sustainable Development Goals target 3.2. Methods Data on 130,773 newborns admitted to 13 hospitals implementing with NEST360 in Kenya were obtained from the Neonatal Inpatient Dataset, between January 2019–October 2024. We described characteristics and primary diagnoses. Logistic regression was used to evaluate factors associated with mortality. Results Among admissions, 114,084 (87.2%) were inborn and 16,689 (12.8%) referred. Referred newborns were more likely to be extremely preterm (6.1% vs 3.1%), have extremely low birthweight (